Friday, November 16, 2012

Teenagers (ages 13-18) are pretty resilient. Not much stops them. Maybe that is one reason that the death of a teen is so shocking and traumatic to us.

The leading causes of death in teenagers are accidents and injuries. But diseases caused by bacteria and viruses also threaten the lives of young people. And many such diseases cause terrible illness even if they don’t cause death. Most people are familiar with meningitis which is a serious infection of the lining of the brain that has a high death rate. Other diseases caused by bacteria and viruses that can make teenagers very sick include measles, rubella, hepatitis B and chickenpox. Fortunately all of these diseases can be prevented by immunization.

The Michigan Department of Community Health, with funding from Novartis, recently undertook an effort to increase the immunization rate among teenagers and the Mid-Michigan District Health Department (MMDHD) had a key role to play. To understand how, you need to know that in Michigan, information on immunizations is stored in a web-based database call the Michigan Care Improvement Registry (MCIR, pronounced “micker”). When someone gets a shot, the person who gives the shot puts the information into MCIR through a web browser. This is very important. No matter where you or your child go in Michigan, your health care provider has up to date information about your immunizations and knows what you need. MCIR is a state-of-the-art system and is known as one of the best immunization databases in the country. There are millions of immunizations in MCIR.

To handle all that information the state is divided into MCIR regions and local health departments have contracts to manage the data in the regions. MMDHD has such a contract, and is responsible for the information in region 3, which includes Barry, Clinton, Eaton, Gratiot, Ingham and Montcalm counties. Here I am just going to write about the three counties in MMDHD’s health department jurisdiction: Clinton, Gratiot and Montcalm.

Reaching out to the families of teenagers who needed immunizations was a straightforward process. The project was led by Hazel Hall who is the region 3 MCIR coordinator. We wanted to find teenagers who needed to be immunized for polio, measles, mumps, rubella, hepatitis B or chickenpox. Hazel had to run reports in MCIR that listed the teens who needed immunizations. Using the reports, letters were printed that told what immunizations the teens needed and these letters were sent to their parents with an invitation to attend an immunization clinic. There were several thousand teens in the three counties who needed shots. We had so many letters to send out that we used volunteers—who happened to be teenagers from Clinton County—to sort and bundle the letters.

The letters went out in July, and they really helped. Sixty-five (65%) percent of teens had up to date immunizations in July; by October it was up to 69 percent. All three counties increased three to four percent. At the end Gratiot had the highest teen immunization rate (74%) and Montcalm improved but was ten points behind (64%). Clinton was in the middle (70%).

Hazel also looked at the percentage of teenagers who had immunizations for meningitis. The percentage of teens who had an immunization against meningitis increased from 68 percent to 73 percent. It increased from 71 percent to 77 percent in Clinton and 73 to 77 percent in Gratiot. In Montcalm it increased from 63 to 67 percent.

MCIR is an amazing system, and using the information helps keep immunization rates high and keeps people safe from disease.

Hazel also looked at the individual physicians and hospitals which have high immunization rates among their patients. I’d like to close by thanking these providers, and listing the names of those who had the highest rates.